Provider Demographics
NPI:1215132691
Name:SAROHA, POOJA (DMD)
Entity type:Individual
Prefix:DR
First Name:POOJA
Middle Name:
Last Name:SAROHA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-2924
Mailing Address - Country:US
Mailing Address - Phone:781-933-1765
Mailing Address - Fax:
Practice Address - Street 1:578 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-2924
Practice Address - Country:US
Practice Address - Phone:781-933-1765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice